Non-Targeted Metabolomics Analysis of Mother and Infant in Gestational Diabetes Mellitus and Neonatal Clinical Characterization.

BACKGROUND: The goal was to analyze serums of GDM patients and healthy pregnant women using HPLC-MS and preliminarily screen differential metabolites by metabolomics. METHOD: Sixty pregnant women who underwent elective cesarean section at term in Dongguan Dalang Hospital from January 2023 to April 2023 were selected and divided into the GDM group and healthy pregnancy group. Pre-pregnancy and pregnancy examination information, such as age, BMI, OGTT results, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and other clinical data were col-lected for statistical analysis. Non-targeted metabolomics of serum from 30 GDM patients and 30 healthy pregnant women were studied by HPLC-MS, and different ions were searched. The structures of differential metabolites were identified by HMDB database. The metabolic pathways of differential metabolites were analyzed by KEGG database. RESULTS: The OGTT result, pCO2, pO2, HCO3, BE, Apgar score, and bilirubin levels in the GDM group were higher than those in the healthy pregnancy group (p < 0.05). However, there were no significant differences in age, triglyceride, total cholesterol, newborn birth weight, newborn birth blood glucose, and blood gas pH between the two groups (all p > 0.05). Using p < 0.05 as the screening standard, 55 differential metabolites were identified in serum, mainly including fatty acyl, carboxylic acids and their derivatives, steroids and their derivatives, ketoacids and their derivatives, and pyrimidine nucleosides, etc., all of which were up-regulated or down-regulated to varying degrees. The 55 metabolites were mainly involved in the metabolism of pyrimidine, pyruvate, alanine, aspartic acid, glutamic acid, and arachidonic acid, glycolysis, and biosynthesis of unsaturated fatty acids. CONCLUSIONS: The discovery of these metabolites provides a theoretical basis for an indepth understanding of GDM pathogenesis. Non-targeted metabonomics analysis of blood metabonomics research technology has shown great potential value in the early diagnosis of obstetric diseases and the study of disease mechanisms.

Case report: Fetal cervical immature teratoma and copy number variations.

Fetal cervical teratoma is a rare congenital neck tumor. Here, we report a case of a fetus with an anterior solid neck tumor that was confirmed to have an immature teratoma by histology. A duplication was found at chromosome 14q24.1-q24.3 of the fetus in chromosome microarray (CMA) and whole exome sequencing (WES), which was a copy number variation (CNV) and a probably new-onset. Ultrasound coupled with magnetic resonance imaging (MRI) can be considered to be a relatively reliable diagnostic tool, whereas ex-utero intrapartum therapy or resection of the tumor mass on placental support may improve the chances of the newborn's survival. Strangely, the same duplication occurred on her next fetus that was found with complex congenital heart malformations. CNV at chromosome 14q24.1-q24.3 needs to be paid more attention.

Urinary Microbial and Metabolomic Profiles in Kidney Stone Disease.

Background: Kidney stones or nephrolithiasis is a chronic metabolic disease characterized by renal colic and hematuria. Currently, a pathogenetic mechanism resulting in kidney stone formation remains elusive. We performed a multi-omic study investigating urinary microbial compositions and metabolic alterations during nephrolithiasis. Method: Urine samples from healthy and individuals with nephrolithiasis were collected for 16S rRNA gene sequencing and liquid chromatography-mass spectroscopy. Microbiome and metabolome profiles were analyzed individually and combined to construct interactome networks by bioinformatic analysis. Results: Distinct urinary microbiome profiles were determined in nephrolithiasis patients compared with controls. Thirty-nine differentially abundant taxa between controls and nephrolithiasis patients were identified, and Streptococcus showed the most significant enrichment in nephrolithiasis patients. We also observed significantly different microbial compositions between female and male nephrolithiasis patients. The metabolomic analysis identified 112 metabolites that were differentially expressed. Two significantly enriched metabolic pathways, including biosynthesis of unsaturated fatty acids and tryptophan metabolism, were also identified in nephrolithiasis patients. Four potentially diagnostic metabolites were also identified, including trans-3-hydroxycotinine, pyroglutamic acid, O-desmethylnaproxen, and FAHFA (16:0/18:2), and could function as biomarkers for the early diagnosis of nephrolithiasis. We also identified three metabolites that contributed to kidney stone size. Finally, our integrative analysis of the urinary tract microbiome and metabolome identified distinctly different network characteristics between the two groups. Conclusions: Our study has characterized important profiles and correlations among urinary tract microbiomes and metabolomes in nephrolithiasis patients for the first time. These results shed new light on the pathogenesis of nephrolithiasis and could provide early clinical biomarkers for diagnosing the disease.

Distribution of Vaginal and Gut Microbiome in Advanced Maternal Age.

The distribution of the microbiome in women with advanced maternal age (AMA) is poorly understood. To gain insight into this, the vaginal and gut microbiota of 62 women were sampled and sequenced using the 16S rRNA technique. These women were divided into three groups, namely, the AMA (age ≥ 35 years, n = 13) group, the non-advanced maternal age (NMA) (age < 35 years, n = 38) group, and the control group (non-pregnant healthy women, age >35 years, n = 11). We found that the alpha diversity of vaginal microbiota in the AMA group significantly increased. However, the beta diversity significantly decreased in the AMA group compared with the control group. There was no significant difference in the diversity of gut microbiota among the three groups. The distributions of microbiota were significantly different among AMA, NMA, and control groups. In vaginal microbiota, the abundance of Lactobacillus was higher in the pregnant groups. Bifidobacterium was significantly enriched in the AMA group. In gut microbiota, Prevotella bivia was significantly enriched in the AMA group. Vaginal and gut microbiota in women with AMA were noticeably different from the NMA and non-pregnant women, and this phenomenon is probably related to the increased risk of complications in women with AMA.

Impact of TPOAb-negative maternal subclinical hypothyroidism in early pregnancy on adverse pregnancy outcomes.

PURPOSE: To investigate the effect of subclinical hypothyroidism on pregnancy outcomes of women early in their pregnancy with different thyroid-stimulating hormone levels and thyroid peroxidase antibody-negative status and to explore reasonable thyroid-stimulating hormone levels for subclinical hypothyroidism in early pregnancy. METHODS: A total of 2378 women early in their pregnancy were studied retrospectively. The baseline characteristics were collected from medical records. Pregnancy outcomes were compared between the euthyroidism and subclinical hypothyroidism groups that were diagnosed by 2011 or 2017 American Thyroid Association guidelines. In addition, the effect of different maternal thyroid-stimulating hormone levels on adverse pregnancy outcomes was analyzed using binary logistic regression. RESULTS: According to the 2011 American Thyroid Association diagnostic criteria of subclinical hypothyroidism, the prevalence of pregnancy outcomes was not significantly higher in the subclinical hypothyroidism group than in the euthyroidism group. However, pregnant women with subclinical hypothyroidism identified by the 2017 American Thyroid Association criteria had a higher risk of premature delivery (odds ratio = 3.93; 95% confidence interval = 1.22-12.64), gestational diabetes mellitus (odds ratio = 2.69; 95% confidence interval = 1.36-5.32), and gestational anemia (odds ratio = 3.28; 95% confidence interval = 1.60-6.75). Moreover, no differences in the prevalence of adverse pregnancy outcomes were observed between the mildly elevated thyroid-stimulating hormone group (2.5 < thyroid-stimulating hormone ⩽4.0 mIU/l) and the normal thyroid-stimulating hormone group (0.27 < thyroid-stimulating hormone ⩽2.5 mIU/l). The significantly elevated thyroid-stimulating hormone group (4.0 < thyroid-stimulating hormone < 10.0 mIU/l) had a higher prevalence of premature delivery, gestational diabetes mellitus, and gestational anemia than the normal thyroid-stimulating hormone group, even after controlling for potential confounding factors. CONCLUSION: A mildly elevated thyroid-stimulating hormone level or maternal subclinical hypothyroidism diagnosed by 2011 American Thyroid Association guidelines during early pregnancy in thyroid peroxidase antibody-negative women was not associated with adverse pregnancy outcomes. However, maternal subclinical hypothyroidism identified by the 2017 American Thyroid Association guidelines increased the risks of several adverse pregnancy outcomes in women untreated with levothyroxine. The 2017 American Thyroid Association guidelines could be more reasonable for the diagnosis of subclinical hypothyroidism in southern China.

Development and Clinical Evaluation of a CRISPR-Based Diagnostic for Rapid Group B Streptococcus Screening.

Vertical transmission of group B Streptococcus (GBS) is among the leading causes of neonatal illness and death. Colonization with GBS usually is screened weeks before delivery during pregnancy, on the basis of which preventive measures, such as antibiotic prophylaxis, were taken. However, the accuracy of such an antenatal screening strategy has been questionable because of the intermittent nature of GBS carriage. We developed a simple-to-use, rapid, CRISPR-based assay for GBS detection. We conducted studies in a prospective cohort of 412 pregnant women and a retrospective validation cohort to evaluate its diagnostic performance. We demonstrated that CRISPR-GBS is highly sensitive and offered shorter turnaround times and lower instrument demands than PCR-based assays. This novel GBS test exhibited an overall improved diagnostic performance over culture and PCR-based assays and represents a novel diagnostic for potential rapid, point-of-care GBS screening.

[Effect of oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 on vaginal Group B Streptococcus colonization and vaginal microbiome in late pregnancy].

OBJECTIVE: To explore the effects of intervention with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 on vaginal Group B Streptococcus (GBS) colonization, pregnancy outcome and vaginal microbiome in GBS-positive women in the third trimester of pregnancy. METHODS: This study were conducted among 155 women in the third trimester of pregnancy with positive results of GBS culture in the Outpatient Department of Zhujiang Hospital from March to November, 2019. After excluding 32 patients who received lactobacillus intervention for less than 2 weeks or underwent postpartum GBS retesting, the women were divided into oral probiotics intervention group (60 cases) and non-intervention group (63 cases). According to the results of GBS retesting, the 60 women in the intervention group were divided into GBS-negative group (18 cases) and persistent GBS-positive group (42 cases). At the end of the intervention, the rates of negative GBS culture result were calculated and the pregnancy outcomes were compared. From 5 women randomly selected from the intervention group, samples of vaginal secretions were collected before and after the intervention for amplicon sequencing and bioinformatics analysis. RESULTS: At the end of the intervention, the GBS-negative rate in the intervention group was 30% (18/60), as compared with 23% (3/13) in the non-intervention group. Probiotic intervention significantly reduced the incidence of premature rupture of membranes (P < 0.05) and reduced the use of antibiotics during pregnancy (P < 0.05). OTU analysis of the vaginal secretions suggested probiotic intervention decreased the total sequence number and GBS sequence number, increased the species composition, and significantly decreased GBS abundance (P < 0.05). Probiotics intervention also significantly decreased the species abundance of Enterococcus, Staphylococcus and Streptococcus in the vaginal flora (P < 0.05). CONCLUSIONS: Intervention with oral probiotics can reduce vaginal GBS colonization in late pregnancy and improve the pregnancy outcome. Lactobacillus is capable of reducing the abundance of GBS and other pathogenic bacteria to improve the microbiome of vaginal flora.

The changing situation about maternal age, risk factors and pregnancy outcomes after the two-child policy: a retrospective cohort study.

BACKGROUND: To evaluate the relationship between gestational age, risk factors, pregnancy outcomes, and the causes and trends of the changes in the incidence of pregnancy in different years after the two-child policy. METHODS: The study enrolled all of the childbirth women (n=7,016) from January 1st, 2015 to December 31th, 2017 in the Zhujiang Hospital. According to the age of all childbirth women, they were divided into four groups: ≤24, 25-29, 30-34 and ≥35 years old. While 20-29 years old group regarded as the control group (OR =1). Pregnancy complications and outcomes data of 4 groups were collected. χ 2 test and binarylogistic regression used as the analyze method. Stratified chi-square used to compare the rates between the pregnancy risk factors, childbirth modes and pregnancy outcomes in different years, which may be affected by the age. RESULTS: Compared with the other groups, women in ≥35 years old showed the highest incidences of chronic medical complications and pregnancy induced complications, so as the abnormal neonatal birth outcomes. While women in ≤24 years old displayed a high risk of preeclampsia. After the childbearing policy change, the maternal age ratio increased year by year. The incidences of various risk factors, delivery modes and adverse pregnancy outcomes were also changed between different years and different age groups. The differences of annual incidence showed a statistical significance besides oligohydramnios. CONCLUSIONS: The study indicated that the changes in childbearing policy lead to the changes of age distribution proportion, which finally caused the changes of risk factors incidence. Furthermore, the advance of medical technology and society also affected the changes of pregnancy risk factors, delivery modes and the pregnancy outcomes in different years.

Prevalence, Biotransformation, and Maternal Transfer of Synthetic Phenolic Antioxidants in Pregnant Women from South China.

Synthetic phenolic antioxidants (SPAs) have been identified as an emerging group of contaminants in recent years. However, there are significant gaps in our knowledge of human prenatal exposure to these synthetic chemicals. In this study, a set of eight SPAs and four major transformation products (TPs) were systematically analyzed in matched samples of maternal plasma, cord plasma, and placenta from a population of pregnant women. Five of the eight target SPAs and all four target TPs were frequently detected in the maternal-placental-fetal unit, indicating prenatal exposure to SPAs and the transfer of SPAs across the placenta. In the three matrices, 2,6-di-tert-butyl-hydroxytoluene (BHT), 2,4-di-tert-butylphenol (DBP), and 2,2'-methylenebis(4-methyl-6-tert-butylphenol) (AO 2246) were identified as the most abundant SPAs, while 2,6-di-tert-butyl-1,4-benzoquinone (BHT-Q) and 2,6-di-tert-butyl-4-hydroxy-4-methyl-2,5-cyclohexadienone (BHT-quinol) were identified as the predominant TPs of BHT. In the maternal plasma, concentrations of both BHT-Q and BHT-quinol were significantly correlated with BHT (p < 0.001), suggesting that the two TPs mainly originated from the biotransformation of BHT itself in pregnant women. The transplacental transfer efficiencies (TTEs) of the SPAs and TPs were structure-dependent and generally less than 1. Significantly higher TTEs for four target TPs than their parent BHT were identified. To our knowledge, this study provides the first evidence that SPAs and TPs transfer across the placenta in pregnant women.

Placental expression of PHLDA2 and IGF2 in selective intrauterine growth restriction in monozygotic twins.

OBJECTIVE: To compare the expression of imprinted genes PHLDA2 and IGF2 in the peripheral blood, placenta and fetal umbilical cord blood from normal single chorionic twins (MCDA) and single chorionic twins combined with sIUGR, in order to explore the pathogenesis relationship between the expression of PHLDA2 and IGF2 with single chorionic twins combined with sIUGR. METHODS: Immunohistochemical method was applied to detect the expression of PHLDA2 and IGF2 in maternal placenta of MCDA and normal MCDA. ELISA method was applied to detect the expression of PHLDA2 and IGF2 in two groups of umbilical cord blood. RESULTS: There was a significant difference in two groups of maternal age and neonatal birth weight (P<0.05). Immunohistochemical results: IGF2 in the normal MCDA maternal placenta was high expression. The number of IGF2-positive cells in MCDA-sIUGR group A1 decreased slightly and the staining decreased slightly. The number of IGF2-positive cells in A2 group was significantly decreased, and the staining was weakened. In normal MCDA placenta, PHLDA2 cells were colorless, or occasionally in pale yellow; the number of PHLDA2 positive cells in MCDA sIUGR A1 group was slightly increased, the staining was light yellow or colorless. In A2 group, the number of positive cells increased significantly, the staining was brown or brownish-yellow. ELISA results showed that there were significant differences in the expression of IGF2 and PHLDA2 between cord blood of MCDA sIUGR and neonatal cord blood (P<0.05). The expression of IGF2 in MCDA sIUGR and normal MCDA twins were also significantly different (P<0.01). CONCLUSION: The differential expression of PHLDA2 and IGF2 may be one of the causes of selective intrauterine growth restriction.

VERTICAL TRANSMISSION OF DENGUE INFECTION: THE FIRST PUTATIVE CASE REPORTED IN CHINA.

Dengue is a systemic viral infection that is commonly transmitted between humans via mosquitoes. Other modes of transmission such as the vertical one are rare and have been infrequently reported in the literature. This report investigates one case of vertical transmission of dengue in Guangzhou, China. A G1P1 lady at 39 weeks of gestation was referred to the Huzhong Hospital presenting a fever for two days. She subsequently developed a skin rash on the back and lower limb and at that time she had already experienced five days of fever. She subsequently went into labor and delivered a female neonate weighting 3,500 g at birth. The neonate developed fever on the third day of life which was associated with a systemic erythematous skin rash. There was no report or evidence of mosquito bites after birth. A complete blood count showed leucopenia, thrombocytopenia and anemia and the liver function test showed elevated AST, GGT and bilirubin. Dengue was diagnosed in the mother and the neonate by the ELISA dengue virus NS1 antigen test (Wantai, Beijing, China) and dengue virus fluorogenic quantitative PCR test (Liferiver, Shanghai, China).The case report illustrates the possibility of the vertical transmission of dengue. Clinicians should be alert to this possibility and institute early treatment. Further direct evidence and research are required.

The Correlation Between Serum Vitamin D Deficiency and Preterm Birth.

BACKGROUND Preterm birth is an important cause of death and developmental disorder in neonates. Vitamin D deficiency has been shown to regulate body inflammatory factor levels that stimulate elevation of uterine contraction hormones, such as prostaglandin, thus causing preterm birth. However, current observations regarding the relationship between vitamin D and preterm birth are inconsistent. We performed a nested case-control study to investigate the effect of vitamin D on preterm birth. MATERIAL AND METHODS A prospective cohort study included 200 cases of pregnant women in our hospital from May 2013 to May 2015. Blood samples were collected from early, middle, and late stages of pregnancy. Forty-six patients with preterm delivery were compared with age-matched full-term delivery cases (N=92). High performance liquid chromatography-mass spectrometry (HPLC-MS) was used to detect serum levels of 25(OH)D, 25(OH)D2, and 25(OH)D3. Logistic regression was performed to analyze the correlation between 25(OH)D and risk of preterm birth. RESULTS No significant difference in age, smoking/drinking, education level, BMI and vitamin D levels was found between the preterm birth group and full-term delivery group. No significant difference was found for vitamin D levels across different stages of pregnancy; no difference in concentration of 25(OH)D related to preterm birth risk was found. After adjusting for potentially confounding factors, serum vitamin D level did not increase the risk of preterm birth. CONCLUSIONS This study did not found evidence of an increase in preterm birth risk related to vitamin D level during pregnancy.

[Relationship between vitamin D receptor gene polymorphism and preterm birth].

OBJECTIVE: To explore the relationship between vitamin D receptor (VDR) gene pol-ymorphisms at Fok I site and the risk of preterm birth for potential intervention of of preterm birth or threatened premature delivery. METHODS: Fifty-seven women with preterm birth and 84 with full-term birth were included in this analysis. Polymerase chain reaction-restriction frag-ment length polymorphism (PCR-RFLP) was performed to identify VDR gene Fok I geno-types. RESULTS: No significant difference was found in age, D-dimer (DDI), fibrinogen (Fg), serum calcium (Ca2+), leukocyte count or glycosylated hemoglobin (HbA1c) level between the women in the preterm and full-term birth groups (P>0.05). The two groups differed signifi-cantly in the distribution of VDR gene Fok I site genotypes and allele frequency of F/F (P<0.05).The frequency of FF genotype was significantly higher in the preterm group than in the full-term group. Compared with Ff and ff genotypes, FF genotype was associated with an in-creased risk of preterm delivery (χ2=9.701, P=9.701, OR=3.320, 95% CI [1.560, 7.066]). In the preterm group, the maternal age, DDI, Fg, serum Ca2+, leukocyte count or HbA1c did not differ significantly between the genotypes (P>0.05). CONCLUSION: VDR gene Fok I site geno-types are related with preterm birth, and the FF genotype may serve as a potential risk factor for preterm birth.

Risk factors for adverse fetal outcomes among women with early- versus late-onset intrahepatic cholestasis of pregnancy.

OBJECTIVE: To determine risk factors for adverse fetal outcomes (AFOs) among women with intrahepatic cholestasis of pregnancy (ICP) on the basis of time of onset. METHODS: In a retrospective analysis, data were obtained for all women with ICP admitted to two centers in Guangzhou, China, between February 1, 1993, and January 31, 2014. Patients were divided into group A (early-onset ICP) and group B (late-onset ICP), and were further divided on the basis of severity. The frequency of AFOs was assessed. RESULTS: Among 371 eligible women, 57 (15.4%) were in group A and 314 (84.6%) in group B. AFOs affected 20 (35.1%) women in group A and 67 (21.3%) in group B (P=0.024), and 12 (54.5%) of 22 women in group A and 21 (29.6%) of 71 in group B with severe ICP (P=0.032). Independent risk factors for AFO in group A were increased levels of serum bile acid (P=0.016) and alkaline phosphatase (P=0.004). Independent risk factors in group B were increased levels of alkaline phosphatase (P<0.001) and gamma-glutamyl transpeptidase (P=0.001). CONCLUSION: Early-onset ICP is associated with a higher frequency of AFO than is late-onset ICP, especially in severe disease. The risk factors differ between early-onset and late-onset ICP.

[Efficacy and safety of intrauterine Bakri balloon tamponade in the treatment of postpartum hemorrhage: a multicenter analysis of 109 cases].

OBJECTIVE: To evaluate the efficacy and safety of the Bakri balloon in the treatment of postpartum hemorrhage (PPH). METHODS: A total of 109 patients with PPH who underwent Bakri balloon insertion after unsuccessful first- line medication from thirteen hospitals in Guangdong from Apr. 2013 to Oct. 2013 were recruited in this study. Bakri balloons were applied via vagina or abdomen depending on the delivery mode. The high risk factors and the causes of the PPH were analyzed. The bleeding volume of before and after placing Bakri balloon, the hemoglobin drop-out value, the interval time between the delivery and applying Bakri, the placement mode, staying time, and the complications were recorded. To stratified analyze the Bakri balloon hemostasis success rate and evaluate its safety. RESULTS: (1) The average amount of 24 hours PPH of all 109 cases was 1 523 ml. Successful hemostasis was achieved in 102 cases after Bakri balloon placement, defined as success group. In the other 7 cases, bleeding were not controlled, defined as failure group (six patients underwent hysterectomy). The overall Bakri balloon hemostasis successful rate was 93.6% (102/109), and the failure rate was 6.4% (7/109). The successful rate in cesarean section group was 94% (93/99), and in vaginal delivery group was 9/10. In the patients with placenta previa, placenta increta or scar uterus, the successful rate of Bakri balloon hemostasis was 88% (45/51), 13/16 and 95% (19/20), respectively, and were slightly below the overall successful rate. (2) Data showed that PPH volume after Bakri balloon placement was significantly lower in the success group (364 ml) than that in the failure group (1 533 ml, P < 0.05). However, the hemoglobin drop-off value and the case number that need blood transfusion had no statistically significant difference (P > 0.05). (3) The Bakri balloons were placed via vagina in 38 cases, and successful hemostasis was achieved in 36 cases, with the successful rate of 95% (36/38). The balloons were placed via cesarean section incision in 71 cases, and succeeded in 66 cases, the successful rate was 93% (66/71). There was no statistically significant difference between the two approaches. The retaining time of Bakri balloon was (22.0 ± 3.0) hours in success group and (3.0 ± 1.0) hours in failure group, with statistically significant difference (P < 0.05). (4) There was no intrauterine infection occurred. Ultrasound scan after 6 weeks postpartum found no abnormal signs in pelvis. All patients were followed up for 2-6 months postpartum, no complications were found. CONCLUSION: Bakri balloon tamponade is an effective, safe, simple and quick approach in the treatment of PPH.

[Expression of hypoxia-inducible factor-1alpha in endometriosis].

OBJECTIVE: To detect the expression of hypoxia-inducible factor-1alpha(HIF-1alpha) in endometriosis and explore the possible role of HIF-1alpha in the pathogenesis of endometriosis. METHODS: Immunohistochemistry was performed to examine the expression of HIF-1alpha in 20 normal endometrium, 20 ectopic endometrium and 68 eutopic endometrium specimens from 68 endometriosis patients, and the results were analyzed statistically. RESULTS: The expression of HIF-1alpha was significantly increased in ectopic endometrium than in normal endometrium (P<0.01), and the expression did not undergo changes with the normal menstrual cycle in the three types of endometrium. CONCLUSION: HIF-1alpha expression increases in ectopic endometrium, suggesting that HIF-1alpha plays an important role in the pathogenesis of endometriosis.

[Clinical analysis of radical hysterectomy plus pelvic lymphadenectomy for patients with malignant uterine tumors: laparoscopy versus laparotomy].

OBJECTIVE: To compare clinical efficacy of laparoscopy with laparotomy in radical hysterectomy plus pelvic lymphadenectomy for patients with malignant uterine tumors. METHODS: This retrospective study population included two groups: (1) 26 patients underwent laparoscopy-assisted radical hysterectomy plus pelvic lymphadenectomy (group laparoscopy) and (2) 27 patients were treated with radical hysterectomy plus pelvic lymphadenectomy through laparotomy (group laparotomy). The tumor stage in these two groups of patients was matched. Multiple clinical parameters were observed and analyzed statistically. RESULTS: Compared to the patients in group laparotomy, the patients in group laparoscopy had a longer operative time (310 vs 238 min), more pelvic lymph nodes removed (22 vs 16), lower volume of blood loss (756 vs 1129 ml), and transfusion (321 vs 746 ml), a shorter postoperative gastrointestinal function recovery time (37 vs 62 h), a quicker return to normal temperature (5 vs 8 d), and a shorter period to use antibiotics (6 vs 8 d) (P < 0.01) However, there were no significant differences in the volume of pelvic drainage (321 vs 216 ml), urination recovery time (13 vs 10 d), number of WBC found (11 x 10(9)/L vs 10 x 10(9)/L), hospital stay (26 vs 28 d) and cost (25 986 vs 22 672 Yuan) between the two groups (P > 0.05). CONCLUSION: The clinical efficacy of radical hysterectomy plus pelvic lymphadenectomy by laparoscopy for patients with malignant uterine tumor is equal to that through laparotomy.

[Laparoscopic radical hysterectomy and pelvic lymphadenectomy: analysis of 14 cases].

OBJECTIVE: To evaluate the feasibility and safety of surgical removal of the tumors through laparoscopy in patients with early-stage uterine cancer. METHODS: A retrospective analysis of the clinical data of 10 cervical cancer and 4 endometrial cancer cases, in which laparoscopic radical hysterectomy and pelvic lymphadenectomy were performed following the same surgical procedures as in laparotomy. RESULTS: The mean operating time was 302 min, and mean estimated blood loss was 760 ml, with the mean postoperative gastrointestinal recovery time of 30 h and average number of removed lymph nodes of 22. CONCLUSION: Laparoscopic surgery has equivalent curative effect to laparotomy, and laparoscopic radical hysterectomy and pelvic lymphadenectomy in the patients with early-stage uterine cancer is both feasible and efficient.

[Establishment of a new rat model of intrauterine growth retardation].

OBJECTIVE: To establish intrauterine growth retardation (IUGR) models in rats for study of the etiology, pathology and therapy of this disease. METHOD: Partial ligation of the medial segment of the uterine artery and vein was performed in 10 Sprague-Dawley rats with pregnancy (17 d) to establish IUGR models, and another 9 rats with pregnancy of the same length which did not receive the operation were used as control. On day 21 of pregnancy, the fetuses and placentas in both groups were surgically taken and weighted, and the incidence of IUGR and mortality in the fetus were observed. RESULTS: Significant decrease in the average weight of the fetuses (3.32+/-0.54 g) and placentas (0.38+/-0.05 g) occurred in the ligated group as compared with those of the control group (4.55+/-0.76 g and 0.44+/-0.11 g, P<0.005). An incidence of IUGR as high as 33.33% was resulted in the fetus of ligation group, significantly higher than that in the control group (1.14%, P<0.005), but no significant difference was observed in the mortality between the 2 groups (4.94% vs 3.41%, P>0.05). CONCLUSION: IUGR models can be successfully established in SD rats by partial ligation of the medial segment of the uterine artery and vein.